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Pharmacology-RN > Test 2 > Flashcards

Test 2 Flashcards

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1
Q

S/s of hypoglycemia

A 
Anxious
Sweating 
Shaking 
Fast heart
Hunger
Dizzy 
Irritable
Headache 
weak 
impaired vision 
Fatigue 
Irritated
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2
Q

What causes hypoglycemia

A 
Too little food
Too much insulin 
Diabetes 
Medicine 
Too much exercise
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3
Q

Onset of hypoglycemia?

A

Sudden,

May progress to insulin shock

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4
Q

Normal blood sugar level ?

What is hypoglycemia level?

A

Normal range: 70-115mg

Blood sugar below 70 is hypoglycemia

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5
Q

What to do to manage S/s of low blood sugar?

A

Drink a cup of orange juice, milk, hard candy

Test glucose with blood monitor

If symptoms don’t go away then call doctor

After 30 min when symptoms go away, eat a light snack such as (half a peanut butter sandwich and half glass of milk

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6
Q

Hyperglycemia s/s

A 
Increased urination 
Dry skin 
Thirsty
Nausea 
Drowsy
Blurred vision 
Hunger
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7
Q

What to do for s/s of high bs?

A

Test blood sugar

If over 250 for several tests , call your doctor

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8
Q

Causes of hyperglycemia

A

Too much food

Too little insulin

Illness

Stress

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9
Q

Onset of hyperglycemia

A

Gradual, may progress to diabetic coma

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10
Q

Hyperglycemia is considered what number?

Acceptable range #

A

Above 200

115-200

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11
Q

What is the antidote to insulin?

A

Glucagon- IV or orally

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12
Q

Risk of taking fluoroquinolones (floxoxacin) cipro

And what helps restore normal flora while taking these?

A

Sunburn

Tendon rupture/ achilies

Don’t take with minerals/milk/dairy (ca, mg, zn) due to lower of effectiveness

-probiotics

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13
Q

How to avoid super infections?

A

Avoid using 4th generation meds unless needed

Take full med course of antibiotics

Don’t take z pack back to back

Take yogurt or probiotics to restore normal flora

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14
Q

What meds/antibiotics should not be taken with yogurt, iron, minerals (calcium, iron, zinc) , dairy?

Why?

A

Those taking tetracyclines, fluroquinolones, Zithromax, or lactose intolerance

Med becomes inactivated by them

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15
Q

How to limit the risk of renal injury?

A

Check peak and trough (lowest level of drug before you give the next dose) levels

Peak: 1 hour after hanging IVPB

Trough: 0.5 hour before next dose

Watch BUN and creative levels

24 hour urine collection

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16
Q

Nitrofurantoin (antimicrobial) administration precaution

A

Take with food to prevent nausea

Take with water

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17
Q

What antibiotic to take on empty stomach

A

Penicillins

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18
Q

All antibiotics should be taken with what?

Why?

A

Water

Protection of kidneys

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19
Q

What antibiotics are harder on kidneys and very important to drink lots of water with?

A

Quinolones

Sulfas

Penicillins

Aminoglycosides

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20
Q

What can happen if given vancomycin too quickly?

How to administer?

A

High BP and Lots of pain when given IM Or IV (some others do too )

Give over 1 hour if given IV

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21
Q

Rocephin can be mixed with what before administering ? (Need approval)

What to do before administering liquid suspensions and why?

A

Mix with lidocaine

Shake Liquid suspension, overdosing will occur if you do not.

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22
Q

What to know with pregnant women or nursing mothers and antibiotics

A

Many can cross placenta or breast milk but infants can’t metabolize

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23
Q

Which antibiotics can counteract birth control

Use secondary bc

A

Penicillins
Tetracyclines
Rifampin

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24
Q

Which antibiotics increase bleeding time

What medication would be reduced at this time if patient were taking?

What else should not be taken with med? Why?

A

Cephalosporins such as keflex

Coumadin

Alcohol - can cause GI symptoms, HTN, flushing, tachycardia

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25
Q

What antibiotic med is inactivated by alcohol

A

Flagyl

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26
Q

What med permanently darken children’s teeth and is contraindicated in children or nursing mothers

A

Tetracyclines

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27
Q

Antibiotics that turn urine brown or orange but not harmful

Which one also can turn tears/ secretions orange ?

Why would a UA be done?

A

Flagyl
Vancomycin
Rifampin

Rifampin

Do see if kidneys were damaged if color does not go away after taking

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28
Q

How often does one take TB antibiotics

What harm can be done to body?

A

9 plus months

Can cause renal or hepatic damage

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29
Q

Which antibiotic should not wear contacts while taking?

A

Rifampin

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30
Q

What should people watch when taking antibiotics with Coumadin

A

INR levels

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31
Q

People often develop allergies to what antibiotics?

What can allergies turn into?

A

Zosyn, penicillin , cephaloporin

Anaphylaxis shock, bronchospasm, Steven Johnson’s syndrome

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32
Q

What to do if rashes or hives appear when taking antibiotics

A

Stop med STAT

Report to provider

Epinephrine and steroids are given (doctors order first)

Antihistamines May control hives (Benadryl)

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33
Q

Only antibiotic that does not prolong bleeding time

A

Amycins

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34
Q

What to assess before and after giving an antibiotic?

A

Skin

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35
Q

What to know about cephalosporins ?

What can cause side effects?

A

No alcohol **
It May cause High Bp and Emesis
(Disulfiram reaction)

High risk allergy

Eat yogurt

36
Q

What to know about vancomycin ?

What labs to watch ? How to give?

A

Nerve deafness risk

Watch BUN , creative, peak, trough (hard on renal)*

Give via central line (hard on veins)- slowly due to risk of low bp *

37
Q

What to know about bactrim (sulfa)

Side effects?

A

Sunburn risk *

Drink lots of water *
or may get Chrystal’s in urine*

Risk of high K *and low platelet

38
Q

Macrolides? (Zmax, Biaxin)

Include risk of what?

A

Risk of arrhythmias

39
Q

Tamiflu (oseltamivir)

What it’s for and what it can cause ??

A

Antiviral to limit influenza s/s

Recommended in pregnant women if have flu

Get flu shot if pregnant

Can cause hallucinations and psychosis *

40
Q

Cytoxan (cyclophosphamide)

Side effects?

A

Hair loss, mouth sores , nausea, fatigue, wary metapause, infection, bleeds

Can be cardio/lung toxic, hepatoxic

Can darken nails

bladder erosion and bleeding**

Drink a lot of water and take in AM

41
Q

Tetracyclines

Side effects? What to use with drug? What not to use ?

A

Permanently darkens teeth **

Don’t give to kids

Teeth darkness is Reversible in doxycycline

Use back up BC**

Sunburn risk **

No minerals with drug **

42
Q

Penicillins

Side effects? What to use with drug?

A

High risk allergy (mold related)

Epi pen and IV steroids for anaphylaxis **

Alternate BC **

Dye free benedryl **

43
Q

Aminoglycosides

What to watch for?

A

Nerve deafness ** risk and renal failure

Report tinnitus **

Watch BUN, creatine , peak , trough **

44
Q

Macrodantin (nitrofurantoin)

Take what with med?

A

Take with milk **

May turn urine brown

Use for Staph UTIs

45
Q

Flagyl (metronidazole)

A

Fights anaerobes and Protozoa (stds)

Don’t take with alcohol -inactivates ** disulfiram reaction

Don’t breastfeed

Can turn urine brown

46
Q

INH isoniazid

Take How long for what?

Take with what to prevent neuropathy ?

A

Safe in OB

Take with B6 (pyridoxine) to prevent neuropathy **

Expect 9 month minimum course **

Less than 1% sustain liver harms

47
Q

Permethrin

Used for what and how to use ? For how long ?

A

1% shampoo for lice

Avoid eyes and ears

Repeat in 7-10 days for lice**

One time use -5% lotion for scabies leave on for 8-12 hours **

Wrap area - 1time application

Sea tea tree **and lavender

48
Q

Adriamycin (doxyrubacin)

Side effects?

A

Hair loss, mouth sores, nausea, fatigue, early menopause, infection, bleeds

Can be hard on heart, ** and hepatotoxic (liver), kidneys

Darkens nails

Turns urine red **

49
Q

Methotrexate

Class? Take with what?

A

Class X

Use BC

Slows cells

Low WBC, platelets, RBC

Take folic acid ** because it interferes with folic acid in body**

Risk of liver and renal harm

Take once a week

50
Q

Steroids (decadron, solucortef and solumedrol

Risks ?

A

Immune suppressor (infection risk)

Report fever , low WBC, infection**

Risk of hyperacidity and bleeding **- take with food

Weight gain

High K if suddenly stop drug And low K during therapy risk *(Addison’s) - High if sudden withdrawal of med

Hypertension and hyperglycemia risk**

Risk of fractures

Avoid long term

Depression risk

Sodium and water retention risk (cushings)*

2 day half life

51
Q

ACTH hormone

Adrenocortitroohic hormone

How it makes cortisol?

A

Stimulates adrenals to make cortisol **

Response will be uncertain

52
Q

Synthroid/levothroxine

S/s

A

T4

Essential for metabolism

Cold, constipated , and nervous is overdose -highTSH **

Febrile, diarrhea, nervous- low tsh **

PTU ( propythiouracil) is the antidote

53
Q

Desmopressin (ADH)

A

Causes we capture a free water from Renal tubules if blood is too concentrated

Retain free water - give if at risk for dehydration *

Hyponatrenia (low sodium) and cerebral edema **(brain) can occur is too much is given

54
Q

Neupogen (filgrastim)

A

Causes rapid regeneration at WBCs after chemo (puts wbc back)

Can cause bone and spleen pain/rupture risk * (bad bleed)

55
Q

Benedryl / diphenhydramine

A

Used for rash (use dye free)

Causes Somnolence (tired/sleepiness) **

Do not drink alcohol*

Anticholinergic effects (dry mouth/urine retention, high pulse)*

Zyrtec and Claritin do not cause drowsiness

56
Q

Aspirin

A

Class C

High acid and bleeding risk (increases INR)**

Gastric erosion risk - take with food)**

Hard on kidneys **

Hyperventilation/acidosis

Nerve deafness risk**

2k mg in elderly dose limit

Baby aspirin Keeps platelets slippery

Do not give to children due to Reye’s syndrome **

57
Q

PTH parathyroid hormone

A

Drives calcium up ** by activating D3 in the kidney to create absorption and renal recapture of calcium

Effects take place in renal failure

58
Q

Calcitonin

A

Produced by the thyroid

Drives calcium down **into bone

Lowers calcium levels

Counterbalances parathyroid hormone

59
Q

Florinef (fludrocortisone)

A

Fake aldosterone

causes retention of sodium and low K fluid retention **

May cause edema, hypertension, and congested heart failure may follow

Given to people with adrenal insufficiency to correct their high K and low sodium levels (addisons)

60
Q

Insulin log (rapid acting) (novalog, apidra, humalog)

When does it start working?

When does it peak ?

What might happen if given too soon before breakfast ?

If given at breakfast ?

Can be mixed with?

A

Starts working 15 minutes and peaks in one hour

Might cause reaction before or during breakfast

Cause reaction before lunch

NpH if not already premixed

61
Q

Short acting insulin/regular (humalin R, Novalin R)

Starts working when?

If given at breakfast, when would reaction occur

A

30 minutes

Peaks in 2-3 hours

Before lunch

62
Q

What does metformin do?

Is it safe?

What effects can occur

A

Helps insulin receptors work properly

It is safe in OB

Lowers liver release of glucose

Decrease of intestinal absorption of glucose

GI side effects

Stop med in renal failure

Can harm kidneys **

Don’t give the day of or 2 days after contrast **

63
Q

Wellchol (colesevelam)

A

Lowers lipids

Must dilute to prevent constipation

GI obstruction and dysphagia risk

Take with meals

*minimum of 4 oz of juice

64
Q

Glucagon

What it does ?

Which route is best?

A

Causes rapid release of glucose via glycogen breakdown

Subq, IM, or IV

IV is best

65
Q

Insulin lantus /long acting

Peak ?

A

No peak - 24 hour release

Reacts in middle of night due to lack of food while it works

66
Q

Insulin NPH/intermediate acting (humalin)

When does it peak

A

Starts working in 1-2 hours

Peaks : 8-10 hours

67
Q

Glipizide (glutatrol)

A

Sulfaonureas are risky in sulfa allergy **

Tells pancreases to make more insulin regardless of BS

1st dose with caution- has resulted in 450 deaths ** due to hypersensitivity ** can cause hypoglycemia

68
Q

Incretin mimetics do what?

Glutides (byetta, victoza, trulicity*)

Route ? Why?

A

Stimulate insulin after meals

Sub q - less risk of low bs

The rest are oral

69
Q

SGL2 inhibitors do what?
(Flozins)

Watch for?

Risks?

A

Lock glucose in the urine

Watch for low BS, UTI, yeast infections *

Risk of dehydration* - push fluids!

70
Q

Of allergic to penicillin one may be allergic to what as well?

A

Cephalosporins

71
Q

When to hold florinef?

A

Potassium is low

72
Q

Is cushings reversible ? Puffiness

A

Yes

73
Q

What to never take with steroids

A

NSAIDs

74
Q

Chemotherapy :

What to do during episode of anemia

A

Space activities with rest

75
Q

Chemotherapy

When platelet counts are low limit what?

A

Risk of bleeding

76
Q

Chemotherapy

How to eat?

A

Small frequent meals and drink protein shakes when not hungry

77
Q

Chemotherapy

What to do when one has continuous loose stools

A

Limit fiber and raw veggies

78
Q

Chemotherapy

How to fight fatigue

A

Drink plenty of water , exercise, and naps

79
Q

Chemotherapy

What to report STAT?

A

S/s of infection

80
Q

Chemotherapy

How to prevent hair loss?

A

Cold caps

81
Q

Chemotherapy

What to do when memory fails

A

Ask for help

82
Q

Chemotherapy

What types of food to avoid

What to eat?

A

Acidic
Spicy
Alkaline foods
Alcohol

To eat: broth, soda, clear liquids / jello popsicles if nauseated

When nausea goes away eat:

chicken, pasta, rice, potatoes, toast, crackers, hot cereal, bananas, canned fruit, yogurt

83
Q

Chemotherapy

Rinse mouth with what

A

Rinse mouth with 1 cup warm water and 1/8 tsp salt and 1/4 tsp soda

84
Q

How to avoid edema

A

Avoid salt and elevate feet

85
Q

What to track and report to provider

A

Pain triggers and sensory changes

Pharmacology-RN (3 decks)

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